Quick Answer

Yes, HCA Healthcare hires individuals with felony convictions for non-licensed support positions. As America largest for-profit hospital operator with 190 hospitals, 2,400+ ambulatory sites, and 300,000+ employees across 20 states and United Kingdom, HCA conducts high-volume hiring creating opportunities for qualified candidates. However, healthcare employment heavily regulated with critical barriers. Mandatory OIG Exclusion List check (LEIE) permanently bars individuals convicted of healthcare fraud, patient abuse, or controlled substance crimes from federal healthcare program participation if listed, cannot work at any Medicare/Medicaid billing facility including all HCA hospitals. Mandatory pre-employment drug screening within 48-72 hours of offer (10-panel urine test). State healthcare worker background check requirements vary (some require fingerprinting, Level 2 checks). Best entry points: Environmental Services (EVS) ($14-$18/hr), Dietary/Food Services ($14-$17/hr), Patient Transport ($15-$19/hr), Laundry Services ($13-$17/hr) where patient care licensing not required. Employment conditional upon passing comprehensive background check, OIG/SAM/FACIS exclusion screening, drug test, and position-specific requirements. Founded 1968 in Nashville, HCA operates under strict compliance due to previous federal settlements requiring enhanced oversight.

Table of Contents

1. Quick Answer

2. Felon-Friendly Scorecard

3. Eligibility Checklist

4. Critical Regulatory Information

5. Company Overview

6. Hiring Policy Analysis

7. Background Check Process

8. Application Strategy

9. Tips for Applicants with Records

10. Benefits Overview

11. Frequently Asked Questions

12. Disclaimer

Felon-Friendly Scorecard

Eligibility Checklist

CRITICAL: Before applying to HCA Healthcare, verify you are not excluded from federal healthcare programs:

• Check OIG Exclusion List (LEIE) FIRST: Visit https://exclusions.oig.hhs.gov and search your name. If listed, you CANNOT work at any Medicare/Medicaid billing facility including all HCA hospitals—this is federal law, not company policy. OIG exclusions result from healthcare fraud, patient abuse/neglect, felony controlled substance convictions, certain licensing board actions. Exclusions last 5 years minimum, often 10+ years, some permanent. If excluded, must wait until exclusion period ends and apply for reinstatement before pursuing healthcare employment.

  
  

• Pass Mandatory Drug Screening: HCA requires pre-employment drug testing (typically 10-panel urine test) within 48-72 hours of conditional offer. Tests for marijuana (including in states where legal—federal healthcare regulations supersede state law), cocaine, opiates (heroin, morphine, codeine), amphetamines (methamphetamine, MDMA), PCP, benzodiazepines, barbiturates, methadone, propoxyphene, and Quaaludes. Failed test results in immediate disqualification with no opportunity to retest. Healthcare workers have access to medications, controlled substances, and vulnerable patients sobriety requirement is non-negotiable safety measure. If currently using any substances, do not apply until completely clean and able to pass screening. Prescription medications must be disclosed with valid prescription documentation legitimate prescriptions do not disqualify but must be verified.

  
  

• No Healthcare Fraud Convictions: Healthcare fraud (Medicare/Medicaid billing fraud, false claims, kickbacks) creates near-permanent barriers regardless of OIG listing. HCA paid $1.7 billion in federal settlements (2000-2003)—company maintains strict fraud compliance. Healthcare fraud convictions heavily scrutinized even if not formally excluded.

  
  

• No Patient Abuse/Neglect History: Any conviction involving abuse, neglect, or exploitation of patients, elderly, disabled, or vulnerable persons creates major barriers. Patient safety paramount in healthcare. Such convictions often result in OIG exclusion and state healthcare worker registry bars.

  
  

• Understand State-Specific Requirements: HCA operates in 20 states with varying healthcare background check laws. Some states require fingerprinting, Level 2 background checks, healthcare worker registries. State disqualifying offenses may exceed federal requirements. Research requirements for specific state/facility.

  
  

• Consider Position Applied For: Non-licensed support positions (EVS, Dietary, Laundry, Transport) have lower barriers than clinical positions (CNA, Medical Assistant, Nursing) which require state licensing board approval. Licensed positions face additional review beyond HCA hiring state boards evaluate criminal history independently.

Critical Regulatory Information

IMPORTANT: HCA Healthcare operates under extensive federal and state healthcare regulations. Understanding these requirements critical for Second Chance applicants.

OIG Exclusion List (LEIE) - Permanent Bar

Office of Inspector General maintains List of Excluded Individuals/Entities (LEIE) per Social Security Act Section 1128. Individuals on LEIE cannot participate in federal healthcare programs (Medicare, Medicaid, CHIP, TRICARE). Since HCA hospitals bill these programs, cannot employ excluded individuals in ANY capacity clinical or non-clinical. Mandatory exclusions (minimum 5 years) result from: Medicare/Medicaid fraud conviction; Patient abuse/neglect conviction; Felony healthcare fraud; Felony controlled substance conviction. Permissive exclusions (3+ years) for various other offenses. Check https://exclusions.oig.hhs.gov BEFORE applying. HCA conducts monthly OIG screening of all employees discovered exclusion after hire = immediate termination.

FACIS and SAM Databases

HCA screens multiple exclusion databases beyond OIG-LEIE: FACIS (Fraud and Abuse Control Information System) aggregates federal and state sanctions, licensing actions, exclusions, disciplinary actions across 1,800+ sources providing comprehensive view of healthcare-related restrictions; SAM (System for Award Management) maintained by General Services Administration lists federal debarments, exclusions, and entities prohibited from receiving federal contracts or benefits; State Medicaid exclusion lists specific to each of HCA 20 operating states; State healthcare worker abuse registries tracking substantiated findings of abuse, neglect, or exploitation in healthcare settings; Professional licensing board disciplinary actions for any licensed positions. Appearing on any database creates barriers depending on nature of listing some are absolute bars (OIG), others require individualized assessment.

Mandatory Drug Screening

Healthcare organizations require pre-employment drug testing due to patient safety, controlled substance access, regulatory compliance. HCA conducts 10-panel urine screening testing marijuana (including in legal states federal healthcare regulations apply), cocaine, amphetamines, opiates, PCP, benzodiazepines, barbiturates, methadone, propoxyphene, methaqualone. Must complete within 48-72 hours of conditional offer. Failed test = disqualification. Random testing may occur post-hire. Prescription medications must be disclosed with documentation.

State Healthcare Background Check Requirements

Healthcare background check requirements vary significantly by state. HCA operates in: Alabama, Alaska, California, Colorado, Florida, Georgia, Idaho, Indiana, Kansas, Kentucky, Louisiana, Missouri, Nevada, New Hampshire, North Carolina, South Carolina, Tennessee, Texas, Utah, Virginia. Some states require: Fingerprint-based FBI background checks; Level 2 background checks for patient care positions; Healthcare worker registry checks; State-specific disqualifying offenses. Research specific state requirements some states have longer lookback periods or additional disqualifying crimes beyond federal requirements.

EEOC Individualized Assessment

Despite healthcare regulations, EEOC requires individualized assessment using Green Factors: nature/gravity of offense, time elapsed, job relevance. HCA cannot implement blanket exclusions beyond legally mandated bars (OIG exclusion, state-specific disqualifying offenses). For offenses not creating automatic disqualification, company must evaluate individually. However, patient safety concerns give healthcare employers broader discretion than many industries.

Company Overview

HCA Healthcare (Hospital Corporation of America) is America largest for-profit hospital operator and one of the nation largest private sector employers, headquartered in Nashville, Tennessee. Founded 1968 by Dr. Thomas Frist Sr., Dr. Thomas Frist Jr., and Jack C. Massey, company pioneered for-profit hospital management and has grown to operate 190 hospitals, 2,400+ ambulatory surgery centers, freestanding emergency rooms, urgent care centers, and physician clinics across 20 U.S. states and United Kingdom. With 300,000+ employees (called "colleagues"), HCA ranks among Fortune 500 companies with annual revenues exceeding $60 billion. Company mission focuses on caring for and improving human life, providing comprehensive healthcare services from emergency care to complex surgical procedures across its nationwide network.

Company operates through regional divisions with distinct hospital brands: American Division covers Florida (HCA Florida Healthcare largest healthcare system in state), Georgia, South Carolina, and Texas (HCA Houston Healthcare major presence in Houston market); National Division spans Alaska, California, Colorado (HealthONE), Idaho, Indiana, Kansas, Kentucky, Louisiana, Missouri, Nevada (Sunrise Health System serving Las Vegas), New Hampshire, North Carolina, South Carolina, Tennessee (TriStar Health—Nashville market leadership), Utah, and Virginia; United Kingdom operations include multiple NHS partnerships. Major hospital brands include Medical City Healthcare (Dallas-Fort Worth), Presbyterian/St. Luke Medical Center (Denver), and regional networks in each market. This geographic scale creates consistent hiring practices, transferability between facilities, and high-volume employment needs across diverse communities and positions.

HCA history includes significant federal compliance issues shaping current hiring culture. Between 2000-2003, company paid federal settlements totaling $1.7 billion to resolve Medicare billing fraud allegations among largest healthcare fraud settlements in U.S. history at the time. Issues involved cost report fraud, kickback arrangements, and improper billing practices across multiple facilities. Result: Company operated under Corporate Integrity Agreement with U.S. Department of Health and Human Services requiring enhanced compliance programs, monitoring, and reporting. While company has since rebuilt reputation and maintains robust compliance infrastructure, this legacy influences conservative approach to backgrounds involving any financial impropriety, healthcare fraud, or billing-related offenses. Current compliance culture includes extensive employee training, anonymous reporting hotlines, regular auditing, and strict background screening all stemming from lessons learned during federal investigation period.

Company Fast Facts

Employees: 300,000+ colleagues; Hospitals: 190 across 20 states + UK; Ambulatory Sites: 2,400+; Headquarters: Nashville, Tennessee; Founded: 1968; Revenue: $60+ billion annually; Fortune 500: Ranked approximately #60; Public Company: NYSE: HCA; Military Friendly: 10+ consecutive years recognition; Job Families: Nursing, Allied Health, Support Services, Corporate, IT, Environmental Services, Food Services, Patient Transport, Administrative.

Hiring Policy Analysis

HCA Healthcare maintains comprehensive background screening for all positions due to healthcare regulatory requirements and patient safety obligations. Company screens OIG/SAM/FACIS exclusion databases, conducts criminal background checks, verifies employment and education, requires drug screening. Specific requirements vary by position, state, and facility. Licensed clinical positions (nursing, respiratory therapy, pharmacy) require additional state licensing board approval beyond HCA hiring decision.

High-volume healthcare employer creates significant hiring needs across all facility types. With 300,000+ workforce and typical healthcare industry turnover rates (especially entry-level support positions averaging 30-40% annual turnover), HCA fills thousands of positions every month across its 190-hospital network. Environmental Services, Dietary, Patient Transport, Laundry Services experience particularly high turnover rates creating continuous openings for qualified applicants.

Company maintains dedicated talent acquisition teams, regular hiring events, partnerships with workforce development organizations, and streamlined electronic application processes to meet ongoing staffing demands. This volume means company cannot categorically exclude all people with criminal records individualized assessment required for non-excluded offenses to maintain adequate staffing levels while ensuring patient safety compliance.

Position-Specific Barriers

Available Positions and Pay

Pay data from 2024-2025 Glassdoor, Indeed, PayScale for HCA Healthcare positions. Ranges vary by location, experience, facility.

Career Path Examples

• Support Services Track: EVS/Dietary ($14-$17/hr) → Senior EVS Technician/Lead ($16-$20/hr) → EVS Supervisor ($40K-$50K annually) → EVS Manager ($50K-$65K annually) → Director of Support Services ($70K-$90K annually).

  
  

• Timeline: 4-7 years for supervisor level, 8-12 years for director. This track allows career advancement without obtaining clinical licenses—progression based on performance, leadership ability, and operational management skills rather than state board approval of criminal history. Internal advancement where record already known and positive employment track record established creates stronger position than external applications. HCA values promoting from within for management positions.

  
  

• Clinical Support Track: EVS → Patient Transport ($15-$19/hr) → CNA certification (state board reviews criminal history for approval) → CNA ($15-$20/hr) → LPN School (1-year program, board approval required) → LPN ($22-$30/hr) → RN Bridge Program (ASN or BSN completion) → RN ($30-$50/hr).

• Timeline: 5-10 years depending on education pace and licensing approvals. Critical consideration: Each clinical license (CNA, LPN, RN) requires state nursing board approval of criminal history separate from HCA hiring decision. Board standards vary significantly by state. Some boards approve old convictions with rehabilitation evidence; others maintain strict disqualifications. Research specific state board requirements before investing in clinical education and training programs.

Background Check Process

What HCA Checks: OIG/SAM/FACIS exclusion database screening (monthly ongoing); Criminal history (county, state, federal); Employment verification; Education

verification; Professional license verification (clinical positions); Drug screening (10-panel urine within 48-72 hours); State healthcare worker registry (varies by state); Fingerprinting (some states/positions). Timeline: 5-14 business days depending on state requirements and position complexity.

Disqualifying Factors

Automatic/Near-Automatic Disqualification: OIG Exclusion List (LEIE)—permanent bar until exclusion removed; Healthcare fraud convictions (Medicare/Medicaid fraud, false claims); Patient abuse, neglect, or exploitation; Felony controlled substance convictions (manufacture, distribution); Sexual offenses against patients or vulnerable persons; Failed drug screening.

High Risk: Recent violent crimes (within 7 years); Theft from patients, elderly, or healthcare settings; Financial crimes involving vulnerable persons; Drug possession with healthcare implications; Multiple felonies suggesting pattern.

Evaluated Individually: Old convictions (10+ years) with rehabilitation; Non-violent property crimes unrelated to healthcare; Drug possession (not trafficking) with treatment; DUI/DWI; Single incidents with strong rehabilitation.

Your Rights as Applicant

FCRA: Written consent before check; Pre-adverse action notice with report copy; 5 days to dispute; Adverse action notice if denied.

EEOC: Individualized assessment for non-excluded offenses; Green Factors evaluation; Cannot deny solely on conviction without job-relatedness.

OIG: Right to request reinstatement after exclusion period; Appeal process for exclusion decisions.

State Rights: Vary by state research specific state healthcare employment laws and expungement options.

Application Strategy

1. Check OIG Exclusion FIRST: Visit https://exclusions.oig.hhs.gov before applying. If listed, do not apply until exclusion ends and reinstatement obtained. Applying while excluded wastes time and creates negative record.

   
   

2. Target Non-Licensed Support Positions: Apply for EVS, Dietary, Laundry, Grounds keeping where no clinical license required. These positions do not require state licensing board approval beyond HCA hiring decision.

   
   

3. Be Honest About History: Healthcare background checks comprehensive. Dishonesty discovered = automatic disqualification. If asked, disclose truthfully. Prepare brief explanation focusing on rehabilitation.

   
   

4. Pass Drug Test: Ensure completely clean before applying. Test within 48-72 hours of offer no time to detox. Marijuana disqualifying even in legal states (federal healthcare regulations).

   
   

5. Research State Requirements: HCA operates in 20 states with varying requirements. Some states more restrictive. Research specific state healthcare employment laws.

   
   

6. Document Rehabilitation: Gather evidence for individualized assessment: employment stability, education, treatment completion, character references.

   
   

7. Apply to High-Turnover Positions: EVS, Dietary experience highest turnover creating continuous openings. Multiple facilities in each market increase opportunities.

   
   

8. Consider Timing: Apply when facilities expanding, opening new units, or after seasonal turnover. Watch careers.hcahealthcare.com for hiring events.

Tips for Applicants with Records

1. OIG Check is Non-Negotiable: If on LEIE, no amount of rehabilitation overcomes this barrier until exclusion ends. Check first, save time.

   
   

2. Start Non-Clinical, Advance Later: EVS/Dietary entry allows proving reliability. Internal advancement where record already known creates pathway. Some employees obtain CNA certification after establishing positive employment history.

   
   

3. Healthcare Fraud Hardest Barrier: Even if not OIG-excluded, healthcare fraud convictions face intense scrutiny given HCA federal settlement history. Other felonies may be more workable than billing fraud.

   
   

4. Patient Safety Paramount: Understand healthcare employers prioritize patient safety above all. Convictions involving violence toward vulnerable persons, theft from patients, abuse/neglect face near-automatic rejection regardless of time elapsed.

   
   

5. Licensed Positions Require Board Approval: CNA, LPN, RN, Pharmacy Tech require state licensing boards to approve criminal history—separate from HCA hiring. Board standards vary by state. Research before pursuing licensure.

Benefits Overview

Compensation: $13-$50/hour depending on position; Competitive healthcare industry pay; Shift differentials (evenings, nights, weekends); Overtime opportunities.

Health Insurance: Medical, dental, vision for full-time employees; Family coverage options; Prescription drug coverage; Mental health services.

Retirement: 401(k) with company match; Stock purchase plan; Long-term savings options.

Education: Tuition reimbursement programs; Student loan assistance; Clinical ladder programs; Certification support.

Paid Time Off: Vacation, sick leave, holidays; Paid parental leave; Personal days.

Career Development: Internal advancement opportunities; Training programs; Leadership development; Transfer between facilities.

Employee Perspectives

Pros: Large employer with job stability; Comprehensive benefits including healthcare; Career advancement opportunities; Multiple locations for transfers; Tuition assistance for education; Military-friendly employer.

Cons: Strict compliance requirements; Comprehensive background screening; Mandatory drug testing; Healthcare environment demands; High-stress patient care settings; Entry-level pay competitive but not highest.

Frequently Asked Questions

1. Does HCA Healthcare hire people with felonies?

   Yes, HCA hires individuals with felonies for non-licensed support positions (EVS, Dietary, Laundry, Transport) subject to passing background check, OIG exclusion screening, and drug test. Critical exception: OIG Exclusion List (LEIE) creates permanent bar—if listed, cannot work at any HCA facility. Healthcare fraud, patient abuse, felony drug convictions often result in OIG exclusion. Old convictions (10+ years) unrelated to healthcare, patient abuse, or fraud generally more acceptable. Licensed clinical positions require state board approval of criminal history.

   
   

2. What is the background check process?

   HCA conducts comprehensive healthcare background screening: OIG/SAM/FACIS exclusion database checks (monthly ongoing); criminal history (county, state, federal); employment/education verification; drug screening (10-panel urine within 48-72 hours); professional license verification for clinical positions; state healthcare worker registry checks; fingerprinting in some states. Timeline 5-14 days depending on state/position. Everything electronic check email promptly.

   
   

3. How far back does the background check go?

   Criminal history lookback varies by state (typically 7 years, some states unlimited). OIG exclusions remain until formally removed (minimum 5 years, often longer). FACIS aggregates records without time limit. State healthcare registries vary. For most non-licensed positions under $75K, FCRA 7-year limit applies to non-conviction information. Clinical positions may have longer lookbacks depending on state licensing requirements.

   
   

4. What types of convictions make hiring difficult?

   Automatic bars: OIG Exclusion (healthcare fraud, patient abuse, felony controlled substances); Failed drug test. Near-automatic: Patient abuse/neglect; Healthcare fraud; Violence against vulnerable persons; Sexual offenses. High scrutiny: Recent violent crimes; Theft from patients/elderly; Drug trafficking; Financial crimes against vulnerable. Individual review: Old convictions (10+ years); Non-violent property crimes; Drug possession with treatment; DUI.

   
   

5. What are the best entry-level roles for applicants with records?

   Environmental Services (EVS) ($14-$18/hr) most accessible—hospital housekeeping, no patient care license, high turnover creates openings. Dietary/Food Services ($14-$17/hr) meal preparation and delivery. Laundry Services ($13-$17/hr) industrial laundry, limited patient contact. Groundskeeping/Facilities (varies) exterior maintenance. These positions require OIG clearance and drug test but not clinical licensure.

   
   

6. Does HCA drug test?

   Yes, mandatory pre-employment drug screening (10-panel urine test) within 48-72 hours of conditional offer. Tests for marijuana (even in legal states), cocaine, opiates, amphetamines, PCP, benzodiazepines, and others. Failed test = disqualification. Random testing may occur post-hire. Healthcare workers access medications and controlled substances sobriety requirement non-negotiable.

   
   

7. When does HCA ask about criminal history?

   Timing varies by state ban-the-box laws HCA operates in 20 states with different requirements. Some states prohibit questions until after interview or conditional offer. In all cases, comprehensive background check conducted after conditional offer. Dishonesty discovered during verification creates automatic disqualification regardless of offense nature.

   
   

8. Can someone advance to clinical positions with a felony?

   Possible but requires state licensing board approval. Path: Start non-clinical (EVS) → Prove reliability → Obtain CNA certification (board reviews history) → Work as CNA → Pursue LPN/RN education → Board approval for nursing license. State nursing boards have varying standards some more restrictive than others. Old convictions with rehabilitation evidence more likely approved than recent offenses. Research specific state board requirements.

   
   

9. How long does the hiring process take?

   Standard: Application → Interview (1-2 weeks) → Conditional offer → Background check/drug test (5-14 days) → Onboarding → Start. Total 3-5 weeks for non-licensed positions. Licensed positions requiring state verification may take longer. Check email promptly process electronic.

   
   

10. What can applicants do to improve chances?

    Check OIG exclusion status FIRST at https://exclusions.oig.hhs.gov; Target non-licensed positions (EVS, Dietary, Laundry); Ensure completely drug-free before applying; Be honest about history—lying worse than conviction; Document rehabilitation evidence; Research state-specific requirements; Apply during hiring events and expansion periods; Consider multiple HCA facilities in your area.

Alternative Second Chance Healthcare Employers

Conclusion

HCA Healthcare offers legitimate Second Chance opportunities in non-licensed support positions for candidates not excluded from federal healthcare programs. As America largest for-profit hospital operator with 300,000+ employees across 190 hospitals, high-volume hiring creates continuous openings especially in Environmental Services, Dietary, Laundry, and Patient Transport where clinical licensure not required.

Critical first step: Check OIG Exclusion List (LEIE) at https://exclusions.oig.hhs.gov BEFORE applying. If listed, cannot work at any Medicare/Medicaid billing facility including all HCA hospitals—this is federal law, not company discretion. Healthcare fraud, patient abuse, felony controlled substance convictions often result in OIG exclusion. Must wait until exclusion period ends and obtain reinstatement before pursuing any healthcare employment.

Best paths for Second Chance applicants: Environmental Services (EVS) ($14-$18/hr) offers highest accessibility—hospital housekeeping requires OIG clearance and drug test but not clinical license. High turnover creates continuous openings. Dietary Services ($14-$17/hr), Laundry ($13-$17/hr), Groundskeeping similarly accessible. Patient Transport ($15-$19/hr) involves more patient contact but remains non-licensed. These positions allow proving reliability for potential internal advancement.

Key success factors: Verify not OIG-excluded before applying this single check determines whether healthcare employment possible; Ensure completely drug-free for mandatory testing within 48-72 hours of conditional offer (marijuana disqualifying even in legal states due to federal healthcare regulations); Target non-licensed support positions initially (EVS, Dietary, Laundry, Transport) where clinical licensure not required; Be completely honest about criminal history throughout application and background process dishonesty discovered creates worse outcome than actual conviction; Document comprehensive rehabilitation evidence including stable employment, education, treatment completion, character references; Research state-specific requirements for HCA facilities in your area (20-state footprint with varying laws); Apply during hiring events, new facility openings, and expansion periods when hiring volume highest; Consider multiple HCA facilities in metropolitan areas to increase opportunities.

Understanding barriers: Healthcare employers prioritize patient safety above all other considerations. Convictions involving patient abuse, healthcare fraud, violence against vulnerable persons face near-automatic rejection. HCA history of $1.7 billion federal fraud settlement creates particularly strict compliance culture around financial impropriety. However, old convictions (10+ years) unrelated to healthcare, patient safety, or fraud receive individualized assessment not automatic disqualification.

Apply Now at careers.hcahealthcare.com

Disclaimer

This guide provides general information and should not be considered legal advice. Healthcare employment regulations complex consult attorneys for case-specific guidance. OIG exclusion creates federal bar beyond company discretion. State requirements vary across HCA 20-state footprint. Licensed positions require state board approval of criminal history separate from employer hiring. Salary data from 2024-2025 Glassdoor/Indeed reports may vary by location, experience, facility. Individual outcomes depend on criminal history specifics, OIG exclusion status, state requirements, drug test results, position applied for. HCA Healthcare name used for informational purposes. FelonFriendlyJobsNow.com makes no warranties about employment outcomes.